Debra L Koreis

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

RN00139853 Issued in WA

Practice address

720 14TH Ave
Longview, WA 98632-2315

Phone

(360) 423-0203

Fax

(360) 577-0187

NPI assigned

Feb 10, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1679105365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 ALAMO RD",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "986119599",
            "telephone_number": "360-562-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322315",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOREIS",
        "first_name": "DEBRA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "RN00139853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Koethke, MS, LMHC, MHP
• Chelcie M Kolaski, CDP
• Venkata Prashanthi Konda, MD
• John Joseph Konikkara, MD
• Joanne E Kooistra
• Eric Koreis, MS, EMT-P
• Debra Perko Kornberg, M.S.
• Joanie M Korpi-Link, LMP
• Isaac Kosydar, CF-SLP
• Emily M Kovach, BA, AAC

• Addiction (Substance Use Disorder) Registered Nurse in Longview, WA
• Providers in Longview, WA by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.